Encapsulating Peritoneal Sclerosis: Case report and Current Status
Journal Title: Archives of Clinical Nephrology - Year 2017, Vol 3, Issue 2
Abstract
Encapsulating peritoneal sclerosis (EPS), is a rare but devastating complication of long-term peritoneal dialysis (PD) with a high mortality rate. The incidence is between 0.5 and 3.3%, decreasing with time. EPS is defined as a clinical syndrome with major signs of gastrointestinal obstruction, inflammatory parameters, radiological and macroscopic changes. Duration of treatment and cessation of PD are the main risk for development of EPS: about 75% of EPS occurred in patients transferred on hemodialysis or in the two years after kidney transplantation. Morphological alterations are disappearance of mesothelial layer, sub-mesothelial fibrosis, interstitial sclerosis and vasculopathy, ultrafiltration failure, fast transport status of the peritoneal membrane, and loss of sodium sieving are the most predicting functional abnormalities. Some biomarkers could be found in the peritoneal effluent. The pathophysiology is probably a consequence of a multiple-hit process in which expression of growth factors and cytokines play a role. Medical strategies (corticosteroids, immunosuppressive drugs, tamoxifen) in association with parenteral nutrition and/or surgery (enterolysis) are discussed. Prevention is the use of physiological peritoneal solutions, icodextrine instead of high glucose concentration solution, and peritoneal lavage after peritoneal dialysis cessation for any reason.
Authors and Affiliations
Rottembourg Jacques, Issad Belkacem
Keywords
Related Articles
- EP ID EP344984
- DOI 10.17352/acn.000025
- Views 79
- Downloads 0
Impact of Glomerular Filtration Rate on Intravenous Thrombolytic Therapy in Acute Ischemic Stroke: A Retrospective Study from a Single Italian Center
Aim: Chronic kidney disease (CKD) is a risk factor for stroke and in-hospital mortality due to stroke. Stroke is highly prevalent in CKD patients. Our aim was to evaluate the impact of glomerular filtration rate in acute...
Bioimpedance: Innovative Approach in Nephrology and Autoimmune Diseases
The composition of the human body is considered a useful diagnostic tool in many medical specialties. The recognition of changes in nutrition and hydration of patients is useful in nephrology and in particular in chronic...
An End-Stage Renal Disease Patient with Invasive Fungal Rhinosinusitis
Mucormycosis is one of the invasive fungal infections particularly in immunocompromised patients with impaired host defense. It is characterized by fungal rhino sinusitis with invasion of adjustment structures including...
Renal biopsy correlation between indications and histopathology diagnosis
Introduction: Renal biopsy is a procedure in which a sample of renal tissue is obtained for microscopic examination. Renal biopsy has contributed greatly to the classification of intrinsic renal diseases and, therefore,...
Steroid Withdrawal Protocols in Renal Transplantation
Corticosteroid use as a component of immunosuppression protocol is widespread, even though their mechanisms of action are imprecise. The burden of metabolic side effects of steroids and the impact on quality of life in k...